2型糖尿病患者肌少症的相关因素分析

Relative factors to sarcopenia in type 2 diabetes patients

目的探讨2型糖尿病患者肌少症的发生情况及其相关因素的关系。方法采用横断面调查方法,选取2015年4月至2015年11月在贵州医科大学附属医院内分泌代谢科住院的2型糖尿病患者450例(男性256例,女性194例)。年龄31~86岁(59.99±11.75)岁。调查一般情况、血液指标及身体成分指标。肌少症根据亚洲肌少症工作组的诊断标准,即以四肢肌肉指数为参照指标:四肢肌量(kg)/身高2(m^2)(relative skeletal muscle mass index,RASM),男性<7.00 kg/m^2、女性<5.40 kg/m^2。结果肌少症患者有64人,总患病率为14.22%。男女患病率分别为19.14%和7.73%(P<0.05)。肌少症组的年龄和肌酐均高于非肌少症组(P<0.05)。肌少症组的体质指数(body mass index,BMI)、A/G脂肪比值(Android/Gynoid fat ratio)及甘油三酯均低于非肌少症组(P<0.05)。多因素Logistic回归分析显示,校正年龄、性别的混杂因素后,吸烟[OR=2.156,95%CI(1.226~3.790)]为肌少症的危险因素,BMI[OR=0.529,95%CI(0.448~0.625)]、A/G脂肪比值[OR=0.007,95%CI(0.001~0.046)]为肌少症的保护因素。结论吸烟是2型糖尿病患者肌少症的危险因素,BMI和A/G脂肪比值可能是肌少症的保护因素。

Objective To investigate the occurrence of sarcopenia in the patients with type 2 diabetes mellitus(T2DM)and the relationship of its related factors.Methods Cross-sectional survey was adopted to select 450 T2DM patients(256 males and 194 females)who were hospitalized in the Department of Endocrinology and Metabolism of Affiliated Hospital of Guizhou Medical University from April 2015 to November 2015.Their general conditions,blood indexes,and body composition indexes were investigated.According to the diagnostic criteria of the Asian Working Group on Sarcopenia,sarcopenia was diagnosed with relative skeletal muscle mass index(RASM)described as appendicular muscle mass divided by height square,with male<7.00 kg/m^2 and female<5.40 kg/m^2.Results There were 64 patients suffering from sarcopenia,with a total prevalence rate of 14.22%.The prevalence rate of males and females was 19.14%and 7.73%,respectively(P<0.05).The age was older and creatinine level was higher in the sarcopenia group than the non-sarcopenia group(P<0.05).The body mass index(BMI),android/gynoid(A/G)fat ratio and triglyceride level were significantly lower in the sarcopenia group compared with the non-sarcopenia group(P<0.05).Multivariate logistic regression analysis showed that after correcting confounding factors including age and gender,smoking(OR=2.156,95%CI:1.226~3.790)was a risk factor,while BMI(OR=0.529,95%CI:0.448~0.625)and A/G fat ratio(OR=0.007,95%CI:0.001~0.046)were protective factors for sarcopenia.Conclusion Smoking is a risk factor for sarcopenia in type 2 diabetic patients.BMI and A/G fat ratio may be protective factors for sarcopenia.